Anti-cd47 antibodies

ABSTRACT

The present invention provides anti-CD47 monoclonal antibodies and related compositions, which may be used in any of a variety of therapeutic and diagnostic methods for the treatment of cancer, ischemic-reperfusion injury, and other diseases.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Application No. 62/536,267, filed Jul. 24, 2017 and U.S. Provisional Application No. 62/419,158, filed Nov. 8, 2016, each of which is incorporated by reference herein in its entirety.

SEQUENCE LISTING

The Sequence Listing associated with this application is provided in text format in lieu of a paper copy, and is hereby incorporated by reference into the specification. The name of the text file containing the Sequence Listing is ABLX_008_02WO_ST25.txt. The text file is 124 KB, was created on Nov. 8, 2017, and is being submitted electronically via EFS-Web.

BACKGROUND Technical Field

The present invention relates generally to anti-CD47 antibodies, compositions and methods of using same. Such antibodies are useful, for example, for treating a variety of diseases, such as oncological and immunological diseases.

Description of the Related Art

CD47 is a five-pass integral membrane protein with a large extracellular domain of 123 amino acids. The biology of CD47 is reviewed in Murata et al., J. Biochem (2014) 155: 335-344. CD47 is a tumor antigen that prevents phagocytosis by SIRP α expressing macrophages. CD47/SIRP α blocking antibodies can induce phagocytosis of tumor cells by macrophages.

Anti-CD47 antibodies that induce phagocytosis may have utility in the treatment of cancer and inflammatory and autoimmune diseases. In particular, CD47 mAbs may be useful for treating cancer as a monotherapy or in combination therapy. Macrophages that have been induced to phagocytose cancer cells by anti-CD47 monoclonal antibodies (mAbs) further stimulate an anti-cancer response by displaying tumor antigens in the MHC to stimulate a secondary immune response against the cancer cells. The importance of macrophages in cancer therapy is reviewed in Weiskopf and Weissman, MAbs (2015) 7: 303-310. CD47 is expressed on cells in normal human tissue in humans. In particular, it is expressed on human erythrocytes (red blood cells, RBCs). Some anti-CD47 antibodies can induce hemagglutination. There is a need for therapeutic candidate CD47 mAbs that exhibit both induction of macrophage phagocytosis of cancer cells and have very low to no hemagglutination at high concentrations.

SUMMARY OF THE INVENTION

The present invention relates to anti-CD47 antibodies. More specifically, it relates to chimeric anti-CD47 antibodies generated from an AlivaMab Mouse, fully human anti-CD47 antibodies produced therefrom, and methods of use thereof.

One aspect of the invention provides an isolated anti-CD47 antibody, or an antigen-binding fragment thereof, comprising i) a heavy chain variable region comprising a VHCDR1 disclosed herein, a VHCDR2 disclosed herein, and a VHCDR3 disclosed herein and ii) a light chain variable region comprising a VLCDR1 disclosed herein, a VLCDR2 disclosed herein, and a VLCDR3 disclosed herein.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:22, the VHCDR2 of SEQ ID NO:43, the VHCDR3 of SEQ ID NO:64, the VLCDR1 of SEQ ID NO:106, the VLCDR2 of SEQ ID NO:127, and the VLCDR3 of SEQ ID NO:148.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:23, the VHCDR2 of SEQ ID NO:44, the VHCDR3 of SEQ ID NO:65, the VLCDR1 of SEQ ID NO:107, the VLCDR2 of SEQ ID NO:128, and the VLCDR3 of SEQ ID NO:149.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:24, the VHCDR2 of SEQ ID NO:45, the VHCDR3 of SEQ ID NO:66, the VLCDR1 of SEQ ID NO:108, the VLCDR2 of SEQ ID NO:129, and the VLCDR3 of SEQ ID NO:150.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:25, the VHCDR2 of SEQ ID NO:46, the VHCDR3 of SEQ ID NO:67, the VLCDR1 of SEQ ID NO:109, the VLCDR2 of SEQ ID NO:130, and the VLCDR3 of SEQ ID NO:151.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:26, the VHCDR2 of SEQ ID NO:47, the VHCDR3 of SEQ ID NO:68, the VLCDR1 of SEQ ID NO:110, the VLCDR2 of SEQ ID NO:131, and the VLCDR3 of SEQ ID NO:152.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:27, the VHCDR2 of SEQ ID NO:48, the VHCDR3 of SEQ ID NO:69, the VLCDR1 of SEQ ID NO:111, the VLCDR2 of SEQ ID NO:132, and the VLCDR3 of SEQ ID NO:153.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:28, the VHCDR2 of SEQ ID NO:49, the VHCDR3 of SEQ ID NO:70, the VLCDR1 of SEQ ID NO:112, the VLCDR2 of SEQ ID NO:133, and the VLCDR3 of SEQ ID NO:154.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:29, the VHCDR2 of SEQ ID NO:50, the VHCDR3 of SEQ ID NO:71, the VLCDR1 of SEQ ID NO:113, the VLCDR2 of SEQ ID NO:134, and the VLCDR3 of SEQ ID NO:155.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:30, the VHCDR2 of SEQ ID NO:51, the VHCDR3 of SEQ ID NO:72, the VLCDR1 of SEQ ID NO:114, the VLCDR2 of SEQ ID NO:135, and the VLCDR3 of SEQ ID NO:156.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:31, the VHCDR2 of SEQ ID NO:52, the VHCDR3 of SEQ ID NO:73, the VLCDR1 of SEQ ID NO:115, the VLCDR2 of SEQ ID NO:136, and the VLCDR3 of SEQ ID NO:157.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:32, the VHCDR2 of SEQ ID NO:53, the VHCDR3 of SEQ ID NO:74, the VLCDR1 of SEQ ID NO:116, the VLCDR2 of SEQ ID NO:137, and the VLCDR3 of SEQ ID NO:158.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:33, the VHCDR2 of SEQ ID NO:54, the VHCDR3 of SEQ ID NO:75, the VLCDR1 of SEQ ID NO:117, the VLCDR2 of SEQ ID NO:138, and the VLCDR3 of SEQ ID NO:159.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:34, the VHCDR2 of SEQ ID NO:55, the VHCDR3 of SEQ ID NO:76, the VLCDR1 of SEQ ID NO:118, the VLCDR2 of SEQ ID NO:139, and the VLCDR3 of SEQ ID NO:160.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:35, the VHCDR2 of SEQ ID NO:56, the VHCDR3 of SEQ ID NO:77, the VLCDR1 of SEQ ID NO:119, the VLCDR2 of SEQ ID NO:140, and the VLCDR3 of SEQ ID NO:161.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:36, the VHCDR2 of SEQ ID NO:57, the VHCDR3 of SEQ ID NO:78, the VLCDR1 of SEQ ID NO:120, the VLCDR2 of SEQ ID NO:141, and the VLCDR3 of SEQ ID NO:162.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:37, the VHCDR2 of SEQ ID NO:58, the VHCDR3 of SEQ ID NO:79, the VLCDR1 of SEQ ID NO:121, the VLCDR2 of SEQ ID NO:142, and the VLCDR3 of SEQ ID NO:163.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:38, the VHCDR2 of SEQ ID NO:59, the VHCDR3 of SEQ ID NO:80, the VLCDR1 of SEQ ID NO:122, the VLCDR2 of SEQ ID NO:143, and the VLCDR3 of SEQ ID NO:164.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:39, the VHCDR2 of SEQ ID NO:60, the VHCDR3 of SEQ ID NO:81, the VLCDR1 of SEQ ID NO:123, the VLCDR2 of SEQ ID NO:144, and the VLCDR3 of SEQ ID NO:165.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:40, the VHCDR2 of SEQ ID NO:61, the VHCDR3 of SEQ ID NO:82, the VLCDR1 of SEQ ID NO:124, the VLCDR2 of SEQ ID NO:145, and the VLCDR3 of SEQ ID NO:166.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:41, the VHCDR2 of SEQ ID NO:62, the VHCDR3 of SEQ ID NO:83, the VLCDR1 of SEQ ID NO:125, the VLCDR2 of SEQ ID NO:146, and the VLCDR3 of SEQ ID NO:167.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, comprises the VHCDR1 of SEQ ID NO:42, the VHCDR2 of SEQ ID NO:63, the VHCDR3 of SEQ ID NO:84, the VLCDR1 of SEQ ID NO:126, the VLCDR2 of SEQ ID NO:147, and the VLCDR3 of SEQ ID NO:168.

In one embodiment, the VH comprises an amino acid sequence of one of SEQ ID NOs:1-21. In another embodiment, the VL comprises an amino acid sequence of one of SEQ ID NOs:85-105. In another embodiment, the VH comprises an amino acid sequence of one of SEQ ID NOs:1-21, and the VL comprises an amino acid sequence of one of SEQ ID NOs:85-105. In one embodiment, the VH and the VL are from the same anti-CD47 AlivaMab Antibody.

In one embodiment, the anti-CD47 antibody, or antigen-binding fragment thereof, is human. In one embodiment, the antibody is chimeric. In certain embodiments, the antibody is selected from a single-variable domain antibody, single chain antibody, a scFv, a bispecific antibody, a multi-specific antibody, a Fab, a F(ab′)2, and a whole antibody.

One aspect of the invention provides a recombinant polynucleotide encoding the anti-CD47 antibody, or antigen-binding fragment thereof, described above. Another aspect of the invention provides an expression vector comprising the recombinant polynucleotide. In another aspect of the invention provides an isolated host cell that comprises the expression vector. One aspect of the invention provides a composition comprising an anti-CD47 antibody, or antigen-binding fragment thereof, described herein and a physiologically acceptable carrier.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 shows that 16 of the 61 antibodies tested substantially or completely blocked binding of human CD47 to SIRP α.

FIG. 2 shows anti-CD47 antibody binding to native human CD47 expressed on the surface of CCRF-CEM human tumor cell line, a T lymphoblastoid cell line (ATCC CCL-119) as detected by flow cytometry.

FIG. 3 shows anti-CD47 mAbs potently induced phagocytosis of CCRF-CEM human tumor cells by macrophages.

FIG. 4 shows anti-CD47 mAbs with little to zero induced hemagglutination of human erythrocytes (RBCs).

FIG. 5 shows the epitope binning of anti-CD47 mAbs.

BRIEF DESCRIPTION OF THE SEQUENCES

TABLE 1 Anti-CD47 AlivaMab Antibody Amino Acid Sequences VH VL (V-D-J) VHCD R1 VHCD R2 VHCD R3 (V-J) VLCD R1 VLCD R2 VLCD R3 SEQ ID SEQ ID SEQ ID SEQ ID SEQ ID SEQ ID SEQ ID SEQ ID Clone NO NO NO NO NO NO NO NO 5 1 22 43 64 85 106 127 148 10 2 23 44 65 86 107 128 149 14 3 24 45 66 87 108 129 150 85 4 25 46 67 88 109 130 151 87 5 26 47 68 89 110 131 152 90 6 27 48 69 90 111 132 153 91 7 28 49 70 91 112 133 154 101 8 29 50 71 92 113 134 155 102 9 30 51 72 93 114 135 156 106 10 31 52 73 94 115 136 157 107 11 32 53 74 95 116 137 158 139 12 33 54 75 96 117 138 159 143 13 34 55 76 97 118 139 160 144 14 35 56 77 98 119 140 161 151 15 36 57 78 99 120 141 162 153 16 37 58 79 100 121 142 163 161 17 38 59 80 101 122 143 164 164 18 39 60 81 102 123 144 165 201 19 40 61 82 103 124 145 166 204 20 41 62 83 104 125 146 167 205 21 42 63 84 105 126 147 168

TABLE 2 Anti-CD47 AlivaMab Antibody Polynucleotide Sequences VH VHCD R1 VHCD R2 VHCD R3 VL VLCD R1 VLCD R2 VLCD R3 SEQ ID SEQ ID SEQ ID SEQ ID SEQ ID SEQ ID SEQ ID SEQ ID Clone NO NO NO NO NO NO NO NO 5 169 190 211 232 253 274 295 316 10 170 191 212 233 254 275 296 317 14 171 192 213 234 255 276 297 318 85 172 193 214 235 256 277 298 319 87 173 194 215 236 257 278 299 320 90 174 195 216 237 258 279 300 321 91 175 196 217 238 259 280 301 322 101 176 197 218 239 260 281 302 323 102 177 198 219 240 261 282 303 324 106 178 199 220 241 262 283 304 325 107 179 200 221 242 263 284 305 326 139 180 201 222 243 264 285 306 327 143 181 202 223 244 265 286 307 328 144 182 203 224 245 266 287 308 329 151 183 204 225 246 267 288 309 330 153 184 205 226 247 268 289 310 331 161 185 206 227 248 269 290 311 332 164 186 207 228 249 270 291 312 333 201 187 208 229 250 271 292 313 334 204 188 209 230 251 272 293 314 335 205 189 210 231 252 273 294 315 336

SEQ ID NO:337 is a 3′ IgG-specific primer.

SEQ ID NO:338 is a 3′ Igκ-specific primer.

DETAILED DESCRIPTION

The present disclosure relates to anti-CD47 antibodies. Ablexis has used its proprietary AlivaMab Mouse technology (See WO 2010/039900 and WO 2011/123708, incorporated herein in their entirety) to generate panels of monoclonal antibodies (mAbs) against human CD47. Antibodies that potently neutralize SIRPα, binding to CD47 were identified within the panel of anti-CD47 AlivaMab antibodies. In one embodiment, anti-CD47 AlivaMab antibodies potently induce phagocytosis of tumor cells by macrophages. In one embodiment, anti-CD47 AlivaMab antibodies that do not induce hemagglutination of erythrocytes, even at high concentration, were identified.

Embodiments of the invention pertain to the use of anti-CD47 antibodies, or antigen-binding fragments thereof, for the diagnosis, assessment and treatment of diseases and disorders associated with CD47 or aberrant expression thereof. The subject antibodies are used in the treatment or prevention of neoplasms, among other diseases. The subject antibodies may also be used in the blocking of ischemia-reperfusion injury.

Portions of variable regions from the AlivaMab antibodies may include all or a combination of the complementarity determining regions (CDRs) of the VH and/or VL. The variable regions may be formatted with constant regions, either native or desirably modified for induction of either up-regulation or down-regulation of various effector functions, in a standard antibody structure (two heavy chains with two light chains). The variable regions may also be formatted as multi-specific antibodies, e.g., bispecific antibodies binding to two different epitopes on CD47 or to two different antigens, one of which is CD47. The variable regions may also be formatted as antibody fragments, e.g., single-domain antibodies comprising a single VH or VL, Fab, Fab′2, or chimeric antigen receptor (CAR). The antibodies may also be used as antibody-drug conjugates, or carry other additions such as small molecule toxins, biologic toxins, cytokines, oligopeptides, RNAs, or CAR-T cells to increase therapeutic modality and/or increase safety.

The practice of the present invention will employ, unless indicated specifically to the contrary, conventional methods of virology, immunology, microbiology, molecular biology and recombinant DNA techniques within the skill of the art, many of which are described below for the purpose of illustration. Such techniques are explained fully in the literature. See, e.g., Current Protocols in Molecular Biology or Current Protocols in Immunology, John Wiley & Sons, New York, N.Y. (2009); Ausubel et al., Short Protocols in Molecular Biology, 3rd ed., Wiley & Sons, 1995; Sambrook and Russell, Molecular Cloning: A Laboratory Manual (3rd Edition, 2001); Maniatis et al., Molecular Cloning: A Laboratory Manual (1982); DNA Cloning: A Practical Approach, vol. I & II (D. Glover, ed.); Oligonucleotide Synthesis (N. Gait, ed., 1984); Nucleic Acid Hybridization (B. Hames & S. Higgins, eds., 1985); Transcription and Translation (B. Hames & S. Higgins, eds., 1984); Animal Cell Culture (R. Freshney, ed., 1986); Perbal, A Practical Guide to Molecular Cloning (1984) and other like references.

Before describing certain embodiments in detail, it is to be understood that this invention is not limited to particular compositions or biological systems, which can vary. It is also to be understood that the terminology used herein is for the purpose of describing particular illustrative embodiments only, and is not intended to be limiting. The terms used in this specification generally have their ordinary meaning in the art, within the context of this invention and in the specific context where each term is used. Certain terms are discussed below or elsewhere in the specification, to provide additional guidance to the practitioner in describing the compositions and methods of the invention and how to make and use them. The scope and meaning of any use of a term will be apparent from the specific context in which the term is used. As such, the definitions set forth herein are intended to provide illustrative guidance in ascertaining particular embodiments of the invention, without limitation to particular compositions or biological systems.

As used in the present disclosure and the appended claims, the singular forms “a,” “an” and “the” include plural references unless the content clearly dictates otherwise.

Throughout the present disclosure and the appended claims, unless the context requires otherwise, the word “comprise”, or variations such as “comprises” or “comprising”, will be understood to imply the inclusion of a stated element or group of elements but not the exclusion of any other element or group of elements.

The terms “antibody” and “immunoglobulin” (Ig) are used interchangeably herein. An antibody may be either membrane bound or secreted. As used herein, the term encompasses not only intact, or “whole”, polyclonal or monoclonal antibodies, but also fragments thereof (such as single-variable domain (VH, VL or combination thereof) antibodies, Fab, Fab′, F(ab′)2, Fv), single chain (ScFv), synthetic variants thereof, naturally occurring variants, fusion proteins comprising an antibody portion with an antigen-binding fragment of the required specificity, humanized antibodies, chimeric antibodies, chimeric antigen receptors (CARs), and any other modified configuration of the immunoglobulin molecule that comprises an antigen-binding site or fragment (epitope recognition site) of the required specificity.

Antibody, or Ig, molecules are typically comprised of two identical heavy chains and two identical light chains linked together through disulfide bonds. Both heavy chains (IgH) and light chains (IgL) contain a variable (V) region or domain and a constant (C) region or domain. The portion of the IgH locus encoding the V region comprises multiple copies of variable (V), diversity (D), and joining (J) gene segments. The portion of the IgL loci encoding the V region comprises multiple copies of V and J gene segments. The V region encoding portion of the IgH and IgL loci undergo gene segment rearrangement, e.g., different combinations of a V, (D) and J gene segments arrange to form the IgH and IgL variable regions, to develop diverse antigen specificity in antibodies. Each variable region comprises three complementarity-determining regions (CDRs) interspersed between the less variable framework regions (FRs). The heavy chain comprises VHCDR1, VHCDR2, and VHCDR3. The light chain comprises VLCDR1, VLCDR2, and VLCDR3. The secreted form of the IgH C region is made up of three C domains, CH1, CH2, CH3, optionally CH4 (Cμ), and a hinge region except for Cμ, which lacks a hinge region. The membrane-bound form of the IgH C region also has membrane and intra-cellular domains. The IgH constant region determines the isotype of the antibody, e.g. IgM, IgD, IgG1, IgG2, IgG3, IgG4, IgA and IgE. It will be appreciated that non-human mammals, such as an AlivaMab Mouse, encoding multiple Ig isotypes will be able to undergo isotype class switching. There are two types of human IgL, Igκ and Igλ.

The term “antigen-binding fragment” as used herein refers to a polypeptide fragment that contains at least one CDR of an immunoglobulin heavy and/or light chain that binds to CD47. In this regard, an antigen-binding fragment of the antibodies may comprise 1, 2, 3, 4, 5, or all 6 CDRs of a VH and VL sequence set forth herein from anti-CD47 antibodies described herein. An antigen-binding fragment of the CD47-specific antibodies described herein is capable of binding to CD47. In certain embodiments, an antigen-binding fragment or an antibody comprising an antigen-binding fragment, prevents or inhibits SIRPα binding to CD47 and subsequent signaling events. In certain embodiments, the antigen-binding fragment binds specifically to and/or inhibits or modulates the biological activity of human CD47.

In certain embodiments, antibodies and antigen-binding fragments thereof as described herein include a heavy chain and a light chain CDR set, respectively interposed between a heavy chain and a light chain framework region (FR) set that provide conformational support to the CDRs and define the spatial relationship of the CDRs relative to each other. As used herein, the term “CDR set” refers to the three hypervariable regions of a heavy or light chain V region. Proceeding from the N terminus of a heavy or light chain, these regions are denoted as “CDR1,” “CDR2,” and “CDR3” respectively. An antigen-binding site, therefore, includes six CDRs, comprising the CDR set from each of a heavy and a light chain V region.

A “Fab” domain or fragment comprises the N-terminal portion of the IgH, which includes the V region and the CH1 domain of the IgH, and the entire IgL. A “F(ab′)₂” domain comprises the Fab domain and a portion of the hinge region, wherein the 2 IgH are linked together via disulfide linkage in the middle hinge region. Both the Fab and F(ab′)₂ are “antigen-binding fragments.” The C-terminal portion of the IgH, comprising the CH2 and CH3 domains, is the “Fc” domain. The Fc domain is the portion of the Ig recognized by cell receptors, such as the FcR, and to which the complement-activating protein, C1q, binds. The lower hinge region, which is encoded in the 5′ portion of the CH2 exon, provides flexibility within the antibody for binding to FcR receptors. An “Fv” fragment includes a non-covalent VH:VL heterodimer including an antigen-binding site. In certain embodiments, single chain Fv (scFv) antibodies are contemplated. A scFv is a covalently linked VH:VL heterodimer which is expressed from a gene fusion including VH- and VL-encoding genes linked by a peptide-encoding linker (Huston et al. (1988) Proc. Nat. Acad. Sci. USA 85(16):5879-5883).

Where bispecific antibodies are to be used, these may be conventional bispecific antibodies, which can be manufactured in a variety of ways (Holliger, P. and Winter G. Current Opinion Biotechnol. 4, 446-449 (1993)), e.g., prepared chemically or from hybrid hybridomas, or may be any of the bispecific antibody fragments mentioned above.

As used herein “chimeric antibody” refers to an antibody encoded by a polynucleotide sequence containing polynucleotide sequences from two or more species, e.g., human and mouse.

As used herein “chimeric Ig chain” refers to an Ig heavy chain or an Ig light chain encoded by a polynucleotide sequence containing polynucleotide sequences from two or more species, e.g., human and mouse. For example, a chimeric Ig heavy chain may comprise a human VH domain, DH domain, JH domain, CH1 domain, and upper hinge region and mouse CH2 and CH3 domains. In one embodiment, the middle hinge region is mouse. In one embodiment, the middle hinge region is human. In one embodiment, the middle hinge region is chimeric.

“Polypeptide,” “peptide” or “protein” are used interchangeably herein to describe a chain of amino acids that are linked together by chemical bonds. A polypeptide or protein may be an IgH, IgL, V domain, C domain, or an antibody.

The strength, or affinity of immunological binding interactions can be expressed in terms of the dissociation constant (K_(D)) of the interaction, wherein a smaller K_(D) represents a greater affinity. Immunological binding properties of selected polypeptides can be quantified using methods well known in the art. One such method entails measuring the rates of antigen-binding site/antigen complex formation and dissociation, wherein those rates depend on the concentrations of the complex partners, the affinity of the interaction, and on geometric parameters that equally influence the rate in both directions. Thus, both the “on rate constant” (K_(on)) and the “off rate constant” (K_(off)) can be determined by calculation of the concentrations and the actual rates of association and dissociation. The ratio of K_(off)/K_(on) enables cancellation of all parameters not related to affinity, and is thus equal to the dissociation constant, K_(D). See, generally, Davies et al. (1990) Annual Rev. Biochem. 59:439-473.

“Polynucleotide” refers to a chain of nucleic acids that are linked together by chemical bonds. Polynucleotides include, but are not limited to, DNA, cDNA, RNA, mRNA, and gene sequences and segments. Polynucleotides may be isolated from a living source such as a eukaryotic cell, prokaryotic cell or virus, or may be derived through in vitro manipulation by using standard techniques of molecular biology, or by DNA synthesis, or by a combination of a number of techniques.

As used herein, the term “vector” refers to a nucleic acid molecule into which another nucleic acid fragment can be integrated without loss of the vector's ability to replicate. Vectors may originate from a virus, a plasmid or the cell of a higher organism. Vectors are utilized to introduce foreign or recombinant DNA into a host cell, wherein the vector is replicated.

A polynucleotide agent can be contained in a vector, which can facilitate manipulation of the polynucleotide, including introduction of the polynucleotide into a target cell. The vector can be a cloning vector, which is useful for maintaining the polynucleotide, or can be an expression vector, which contains, in addition to the polynucleotide, regulatory elements useful for expressing the polynucleotide and, where the polynucleotide encodes an RNA, for expressing the encoded RNA in a particular cell, either for subsequent translation of the RNA into a polypeptide or for subsequent trans regulatory activity by the RNA in the cell. An expression vector can contain the expression elements necessary to achieve, for example, sustained transcription of the encoding polynucleotide, or the regulatory elements can be operatively linked to the polynucleotide prior to its being cloned into the vector.

An expression vector (or the polynucleotide) generally contains or encodes a promoter sequence, which can provide constitutive or, if desired, inducible or tissue specific or developmental stage specific expression of the encoding polynucleotide, a poly-A recognition sequence, and a ribosome recognition site or internal ribosome entry site, or other regulatory elements such as an enhancer, which can be tissue specific. The vector also can contain elements required for replication in a prokaryotic or eukaryotic host system or both, as desired. Such vectors, which include plasmid vectors and viral vectors such as bacteriophage, baculovirus, retrovirus, lentivirus, adenovirus, vaccinia virus, alpha virus and adeno-associated virus vectors, are well known and can be purchased from a commercial source (Promega, Madison Wis.; Stratagene, La Jolla Calif; GIBCO/BRL, Gaithersburg Md.) or can be constructed by one skilled in the art (see, for example, Meth. Enzymol., Vol. 185, Goeddel, ed. (Academic Press, Inc., 1990); Jolly, Canc. Gene Ther. 1:51-64, 1994; Flotte, J. Bioenerg. Biomemb 25:37-42, 1993; Kirshenbaum et al., J. Clin. Invest 92:381-387, 1993; each of which is incorporated herein by reference).

The term “construct” as used herein refers to a sequence of DNA artificially constructed by genetic engineering, recombineering or synthesis. In one embodiment, the DNA constructs are linearized prior to recombination. In another embodiment, the DNA constructs are not linearized prior to recombination.

The terms “inhibit”, “neutralize”, and “antagonize” are used interchangeably herein and encompass anti-CD47 antibodies that block, inhibit, and/or decrease the activity of CD47. Examples of CD47 activity include ligand binding, e.g., binding to SIRPα.

The term “treating” with regard to a subject, refers to improving at least one symptom of the subject's disease or disorder. Treating includes curing, improving, or at least partially ameliorating the disease or disorder.

As used herein, the term “disorder” refers to, and is used interchangeably with, the terms disease, condition, or illness.

The term “pharmaceutically acceptable carrier” refers generally to any material (e.g., carrier, excipient, or stabilizer) that may accompany a therapeutic agent and is nontoxic to the subject or patient being exposed thereto.

The term “administering,” as used herein, refers to any mode of transferring, delivering, introducing, or transporting a pharmaceutical composition or other agent, such as an anti-CD47 antibody, to a subject. Such modes include oral administration, topical contact, intravenous, intraperitoneal, intramuscular, intranasal, or subcutaneous administration.

The term “inhibit” or “neutralize” or “block” may relate generally to the ability of one or more anti-CD47 antibodies of the invention to decrease a biological activity of CD47, such as intracellular signaling and/or ligand binding. The inhibition/blocking of SIRPα to CD47 preferably reduces or alters the normal level or type of cell signaling that occurs when SIRPα binds to CD47 without inhibition or blocking. Inhibition and blocking are also intended to include any measurable decrease in the binding of SIRPα to CD47 when in contact with an anti CD47 antibody as disclosed herein as compared to the ligand not in contact with an anti CD47 antibody, e.g., the blocking of SIRPα to CD47 by at least about a 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or 100% decrease, including all integers in between. In one embodiment, a neutralizing anti-CD47 antibody inhibits binding of SIRPα to CD47 by at least about a 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 11%, 12%, 13%, 14% 15%, 16%, 17%, 18%, 19%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or 100% decrease, including all integers in between.

An antibody, or antigen-binding fragment thereof, is said to “specifically bind,” “immunologically bind,” and/or is “immunologically reactive” to CD47 if it reacts at a detectable level (within, for example, an ELISA assay) with CD47, and does not react detectably with unrelated polypeptides under similar conditions. Antibodies are considered to specifically bind to a target polypeptide when the binding affinity is at least 1×10⁻⁷ M or, preferably, at least 1×10⁻⁸ M. In one embodiment, the antibody, or antigen-binding fragment thereof, specifically binds human CD47.

Each embodiment in this specification is to be applied mutatis mutandis to every other embodiment unless expressly stated otherwise.

Standard techniques may be used for recombinant DNA, oligonucleotide synthesis, and tissue culture and transformation (e.g., electroporation, lipofection). Enzymatic reactions and purification techniques may be performed according to manufacturer's specifications or as commonly accomplished in the art or as described herein. These and related techniques and procedures may be generally performed according to conventional methods well known in the art and as described in various general and more specific references that are cited and discussed throughout the present specification. Unless specific definitions are provided, the nomenclature utilized in connection with, and the laboratory procedures and techniques of, molecular biology, analytical chemistry, synthetic organic chemistry, and medicinal and pharmaceutical chemistry described herein are those well-known and commonly used in the art. Standard techniques may be used for recombinant technology, molecular biological, microbiological, chemical syntheses, chemical analyses, pharmaceutical preparation, formulation, and delivery, and treatment of patients.

CD47

CD47, or integrin associated protein (IAP) is expressed by a variety of cells, including, e.g., erythrocytes, and it is plays a role in a variety of cellular processes. Overexpression of CD47 is associated with proliferative diseases and disorders (e.g., neoplasms, tumors and metastases). CD47 is up-regulated in ischemia-reperfusion injury (IRI), and CD47 knock-out mice are projected in models of IRI. Thus, CD47 is an important therapeutic target for both proliferative diseases and disorders and transplants.

Anti-CD47 Antibodies

AlivaMab Mouse anti-CD47 antibodies were generated using both AlivaMab Mouse Kappa mice and AlivaMab Mouse Lambda mice (also referred to herein interchangeably as AlivaMab Kappa Mice and AlivaMab Lambda Mice, respectively). Antibodies produced by AlivaMab Kappa Mice comprise a chimeric immunoglobulin heavy (IgH) chain and a human immunoglobulin kappa (Igκ) light chain. Antibodies produced by AlivaMab Lambda Mice comprise a chimeric IgH chain and a human immunoglobulin lambda (Igλ) light chain. The chimeric IgH chain of the AlivaMab Mouse antibodies comprises a human variable region comprising a human variable heavy (VH) domain, a human diversity heavy (DH) domain, and a human joining heavy (JH) domain, a human constant heavy 1 (CH1) domain, a human upper hinge region (except for Cμ, which is naturally missing an upper hinge region), a mouse middle hinge region, a mouse CH2 domain, and a mouse CH3 domain. Upon identification of a lead candidate antibody, e.g., an anti-CD47 antibody, the human heavy chain variable region is readily appended to a fully human constant region while maintaining the antigen-binding characteristics of the parent chimeric antibody that were developed in vivo in the AlivaMab Mouse. In one embodiment, the human heavy chain variable region, CH1 and, optionally, upper hinge region of the chimeric antibody are appended to human hinge, a human CH2 domain and a human CH3 domain in order to produce a fully human antibody.

Accordingly, in one embodiment, an anti-CD47 antibody, or an antigen-binding fragment thereof, of the invention is chimeric. In one embodiment, the chimeric anti-CD47 antibody, or an antigen-binding fragment thereof, comprises a chimeric IgH chain and a human Igκ chain. In one embodiment, the chimeric anti-CD47 antibody, or an antigen-binding fragment thereof, comprises a chimeric IgH chain and a human Igλ chain. In one embodiment, the chimeric anti-CD47 antibody is human and mouse. In one embodiment, an anti-CD47 antibody, or an antigen-binding fragment thereof, of the invention is human. In one embodiment, the human anti-CD47 antibody, or an antigen-binding fragment thereof, comprises a human IgH chain and a human Igκ chain. In one embodiment, the human anti-CD47 antibody, or an antigen-binding fragment thereof, comprises a human IgH chain and a human Igλ chain. In one embodiment, the isotype of the anti-CD47 antibody is selected from IgM, IgD, IgG1, IgG2, IgG3, IgG4, IgA and IgE. In one embodiment, the isotype of the anti-CD47 antibody is selected from IgG1, IgG2, IgG3, and IgG4.

In one embodiment, the anti-CD47 antibody binds an Fc receptor (FcR) selected from an FcγR, an FcεR, and an FcαR. In one embodiment, the anti-CD47 antibody binds an FcγR selected from FcγRI (CD64), FcγRII (CD32), and FcγRIII (CD16), including isoforms thereof. In one embodiment, the Fc region of the anti-CD47 antibody comprises a mutation so that it preferentially binds a particular FcγR (see, e.g., U.S. Pat. No. 6,737,056 and U.S. 2015/0031862).

In one aspect of the invention, the CDRs of an anti-CD47 antibody, or antigen-binding fragment thereof, may be mixed and matched between the CDRs of antibody clones described herein. In one embodiment, an anti-CD47 antibody, or antigen-binding fragment thereof, comprises a VHCDR1 comprising any VHCDR1 sequence disclosed herein, a VHCDR2 comprising any VHCDR2 sequence disclosed herein, and a VHCDR3 comprising any VHCDR3 sequence disclosed herein. In one embodiment, the VHCDR1, VHCDR2 and VHCDR3 are selected from three different anti-CD47 clones disclosed herein. In one embodiment, the VHCDR1, VHCDR2 and VHCDR3 are selected from two different anti-CD47 clones disclosed herein.

In one embodiment, an anti-CD47 antibody, or an antigen-binding fragment thereof, comprises a VLCDR1 comprising any VLCDR1 sequence disclosed herein, a VLCDR2 comprising any VLCDR2 sequence disclosed herein, and a VLCDR3 comprising any VLCDR3 sequence disclosed herein. In one embodiment, the VLCDR1, VLCDR2 and VLCDR3 are selected from three different anti-CD47 clones disclosed herein. In one embodiment, the VLCDR1, VLCDR2 and VLCDR3 are selected from two different anti-CD47 clones disclosed herein.

In one aspect of the invention, the CDRs of an anti-CD47 antibody, or antigen-binding fragment thereof, are from the same anti-CD47 antibody clone disclosed herein. In one embodiment, an anti-CD47 antibody, or an antigen-binding fragment thereof, comprises a VHCDR1, a VHCDR2 and a VHCDR3 from the same anti-CD47 clone disclosed herein. In one embodiment, an anti-CD47 antibody, or an antigen-binding fragment thereof, comprises a VHCDR1, a VHCDR2, and a VHCDR3 comprising the corresponding sequences disclosed herein.

In another aspect of the invention, the CDRs of an anti-CD47 antibody, or antigen-binding fragment thereof, are selected from the corresponding VH and VL of a single clone described herein. In one embodiment, an anti-CD47 antibody, or an antigen-binding fragment thereof, comprises 1) a VHCDR1, a VHCDR2, and a VHCDR3 selected from the VHCDR1, VHCDR2 and VHCDR3 of one VH selected from any one of the VH regions disclosed herein and 2) a VLCDR1, a VLCDR2, and a VLCDR3 selected from the VLCDR1, VLCDR2 and VLCDR3 of one VL selected from any one of the VL regions disclosed herein. In one embodiment, an anti-CD47 antibody, or antigen-binding fragment thereof, comprises a VHCDR1, a VHCDR2, a VHCDR3, a VLCDR1, a VLCDR2, and a VLCDR3 within the corresponding VH and VL amino acid sequences of a single clone as disclosed herein.

In one embodiment, an anti-CD47 antibody, or antigen-binding fragment thereof, comprises a VH comprising any one of the VH regions disclosed herein. In one embodiment, an anti-CD47 antibody, or antigen-binding fragment thereof, comprises a VL comprising any one of the VL regions disclosed herein. In one embodiment, an anti-CD47 antibody, or an antigen-binding fragment thereof, comprises a corresponding VH and VL of a single clone.

In one embodiment, an anti-CD47 antibody is a whole antibody. In one embodiment, an anti-CD47 antibody is a single chain antibody. In one embodiment, an anti-CD47 antibody is a scFv. In one embodiment, an anti-CD47 antibody is a Fab. In one embodiment, an anti-CD47 antibody is a F(ab′)₂. In one embodiment, an anti-CD47 antibody is a Fv.

In one embodiment, an anti-CD47 antibody is a bispecific antibody. In one embodiment, a bispecific anti-CD47 antibody specifically recognizes two different epitopes of CD47. In one embodiment, a bispecific anti-CD47 comprises a first CDR set comprising the VHCDR1, VHCDR2, VHCDR3, VLCDR1, VLCDR2, and VLCDR3 from a first anti-CD47 antibody clone disclosed herein and a second CDR set comprising the VHCDR1, VHCDR2, VHCDR3, VLCDR1, VLCDR2, and VLCDR3 of a second anti-CD47 antibody clone disclosed herein. In one embodiment, a bispecific anti-CD47 comprises a corresponding first VH and first VL of a first anti-CD47 antibody clone disclosed herein and a corresponding second VH and second VL of a second anti-CD47 antibody clone disclosed herein. In one embodiment, a bispecific anti-CD47 antibody specifically recognizes CD47 and another antigen.

Polynucleotides

One aspect of the present invention provides a polynucleotide sequence that encodes an anti-CD47 antibody, or antigen-binding fragment thereof, disclosed herein. In one embodiment, the polynucleotide is a recombinant polynucleotide. In one embodiment, the polynucleotide is cDNA.

In one embodiment, a polynucleotide sequence encodes a CDR of an anti-CD47 antibody disclosed herein. In one embodiment, the polynucleotide comprises a VHCDR1 polynucleotide sequence disclosed herein. In one embodiment, the polynucleotide comprises a VHCDR2 polynucleotide sequence disclosed herein. In one embodiment, the polynucleotide comprises a VHCDR3 polynucleotide sequence disclosed herein. In one embodiment, the polynucleotide comprises a VLCDR1 polynucleotide sequence disclosed herein. In one embodiment, the polynucleotide comprises a VLCDR2 polynucleotide sequence disclosed herein. In one embodiment, the polynucleotide comprises a VLCDR3 polynucleotide sequence disclosed herein.

In one embodiment, a polynucleotide sequence encodes a VH of an anti-CD47 antibody disclosed herein. In one embodiment, a polynucleotide sequence encodes a VL of an anti-CD47 antibody disclosed herein. In one embodiment, a polynucleotide sequence encodes a VH and a VL of an anti-CD47 antibody disclosed herein.

One embodiment of the invention provides a vector comprising a polynucleotide sequence encoding an anti-CD47 antibody, or an antigen-binding fragment thereof, disclosed herein. In one embodiment, the vector is an expression vector. In one embodiment, the vector is a cloning vector. One embodiment of the invention provides a host cell comprising the vector.

Methods of Use

The AlivaMab antibodies against CD47, and in particular fully human antibodies incorporating all or portions of the heavy chain and light chain variable regions from the AlivaMab antibodies, may have utility for the treatment of human disease including, but not limited to, diseases in oncology and ischemia-reperfusion injury (IRI). As the understanding of CD47 biology and disease association becomes better known, it is expected that opportunities for human clinical therapeutic indications may expand. In particular, oncological diseases and disorders and IRI prevention are contemplated.

An anti-CD47 antibody, or antigen-binding fragment thereof, disclosed herein may be used in research, diagnostic, and/or therapeutic methods. In one embodiment, an anti-CD47 antibody, or antigen-binding fragment thereof, disclosed herein is used to treat diseases and disorders associated with CD47 and/or SIRPα. In one embodiment, an anti-CD47 antibody, or antigen-binding fragment thereof, disclosed herein is used to treat diseases and disorders associated with CD47 overexpression. In one embodiment, an anti-CD47 antibody, or antigen-binding fragment thereof, disclosed herein is used to induce phagocytosis by macrophages. In one embodiment, an anti-CD47 antibody, or antigen-binding fragment thereof, disclosed herein exhibits little to zero hemagglutination of erythrocytes.

Modified Anti-CD47 Antibodies and Compositions

Anti-CD47 antibodies of the present invention, and antigen-binding fragments and variants thereof, may also be conjugated or operably linked to another compound (e.g., therapeutic agent, label, or tag), referred to herein as a conjugate. The conjugate may be a cytotoxic agent, a chemotherapeutic agent, a cytokine, an anti-angiogenic agent, a tyrosine kinase inhibitor, a toxin, a radioisotope, or other therapeutically active agent. Chemotherapeutic agents, cytokines, anti-angiogenic agents, tyrosine kinase inhibitors, and other therapeutic agents are contemplated. In one embodiment, the antibody is conjugated or operably linked to a toxin, including but not limited to small molecule toxins and enzymatically active toxins of bacterial, fungal, plant, animal or synthetic origin, including fragments and/or variants thereof.

There are many linking groups known in the art for making antibody conjugates, including, for example, those disclosed in U.S. Pat. No. 5,208,020 or EP Patent 0425235 B1, and Chari et al., Cancer Research 52: 127-131 (1992). The linking groups include disulfide groups, thioether groups, acid labile groups, photolabile groups, peptidase labile groups, or esterase labile groups, as disclosed in the above-identified patents, disulfide and thioether groups being preferred.

The present invention further relates to pharmaceutical compositions and methods of use. The pharmaceutical compositions of the present invention include an antibody, or fragment thereof, in a pharmaceutically acceptable carrier. Pharmaceutical compositions may be administered in vivo for the treatment or prevention of a disease or disorder. Furthermore, pharmaceutical compositions comprising an antibody, or a fragment thereof, of the present invention may include one or more agents for use in combination, or may be administered in conjunction with one or more agents. Agents for use in combination with an anti-CD47 antibody disclosed herein include, but are not limited to cytotoxic agents, chemotherapeutic agents, cytokines, anti-angiogenic agents, tyrosine kinase inhibitors, toxins, and radioisotopes.

The present invention also provides kits relating to any of the antibodies, or fragments thereof, and/or methods described herein. Kits of the present invention may include diagnostic or therapeutic agents. A kit of the present invention may further provide instructions for use of a composition or antibody and packaging. A kit of the present invention may include devices, reagents, containers or other components. Furthermore, a kit of the present invention may also require the use of an apparatus, instrument or device, including a computer.

EXAMPLES Example 1 Generation of Monoclonal Antibodies to CD47

Monoclonal antibodies were prepared in accordance with a general method as described in “Antibodies: A Laboratory Manual” (Harlow and Lane 1988 CSH Press). Two AlivaMab Kappa Mice were immunized using a RIMMS protocol. 50 μg of human CD47 extracellular domain with a histidine- (HIS-) tag (Sino Biological, China) was mixed with 40 μl (first immunization), 20 μl (immunizations 2-4) or 0 μl (final immunization) Gerbu MM adjuvant (C-C Biotech, Valley Center, CA #3001-6030) and PBS was added to a final volume of 100 μl. The 50 μg mixture was injected in 20 μl portions in 5 locations per mouse; right and left flanks and right and left shoulder/armpit subcutaneously, and the remaining 20 μl intraperitoneally. This was done 5 times per mouse on days, 1, 4, 7, 9, and 11. On Day 14 mice were sacrificed and terminal materials were collected. Spleens and lymph nodes were prepared and fused with CRL-2016 myeloma cells (ATCC) using a PEG based method as generally described in “Antibodies: A Laboratory Manual” (Harlow and Lane 1988 CSH Press) to establish hybridomas.

Hybridomas were grown in 384-well tissue culture plates and supernatants from individual wells were screened by ELISA for production of antibodies recognizing huCD47. Positive wells were then transferred to 48-well plates, expanded, and supernatants were collected for huCD47 binding confirmation by ELISA. Positive supernatants were also counter-screened against a non-related histidine-tagged protein. One hundred forty-seven (147) ELISA-positive (100× above background) were identified. Sixty-seven (67) hybridoma lines confirmed to bind CD47 specifically by ELISA were picked at random and single-cell cloned into 96-well plates. All 67 hybridoma lines were stable and single-cell cloned and were re-confirmed to produce monoclonal antibody binding to huCD47 in ELISA. Sixty-one hybridoma lines were advanced for subsequent analysis. The isotypes of the mouse Fc on the AlivaMab antibodies were determined using standard commercially available isotyping kits.

Example 2 Screen for Neutralization of Binding of SIRP α to CD47 in ELISA

Sixty-one hybridoma clones were screened for inhibition of SIRP α binding to CD47. Briefly, recombinant CD47-Fc (Sino Biologics) at 1 μg/ml in phosphate-buffered saline (PBS) plus 0.05% TWEEN was coated onto the bottom of 96-well ELISA plates overnight. The plates were washed two-times in PBS and non-specific binding was blocked by one-hour incubation at room temperature with SuperBlock™. Unrelated antibody isotype controls (negative control) and recombinant blocking CD47 monoclonal antibody B6H12 (positive control) were used at 20 μg/ml. Supernatants from cloned hybridoma lines were added at a 1:2 dilution. All samples were in triplicate. The antibodies were incubated with plate-bound human CD47-Fc for 15 minutes at room temperature and then recombinant human HIS-tagged SIRP α was added at 2 μg/ml. The plates were incubated for 1 hour at room temperature and then washed two times with PBS plus 0.05% TWEEN. An anti-HIS-tag antibody was added and incubated for one hour. The anti-HIS-tag antibody detects HIS-tagged SIRP α bound to human CD47-Fc. The plates were incubated for 1 hour at room temperature and then washed two times with PBS plus 0.05% TWEEN. SuperSignal™ at 20 μg/ml was added and binding signal detected on a plate reader. The lower the RU signal the greater the ability of antibody to block binding of human CD47 to SIRP α. Sixteen of the 61 antibodies tested substantially or completely blocked binding of human CD47 to SIRP α (FIG. 1).

TABLE 3 CD47 AlivaMabs That Block the Binding of Human CD47 to Human SIRP α LIST OF MONOCLONAL ANTIBODIES THAT BLOCK HUMAN CD47 BINDING TO SIRP α 5 10 14 85 87 91 101 102 106 107 139 144 151 153 161 164

Example 3 Screen for Binding to Native Human CD47 Expressed in Cell Surface

The sixty-one monoclonal antibodies were screened for binding to native human CD47 expressed on the surface of the CCRF-CEM human tumor cell line, a T lymphoblastoid cell line (ATCC CCL-119) by flow cytometry (FACS). Twenty of 65 antibodies tested bound to native CD47 as assessed by FACS. Sixteen were assessed as strong binders and four were assessed as weak binders (FIG. 2). Binding in the FACS correlated with inhibition of binding to SIRP α. The low level of FACS positive binders to human CD47 expressed on the surface of human cells suggests that the recombinant human CD47 used for immunization and screening of the hybridomas poorly represented the native conformation of human CD47.

TABLE 4 CD47 AlivaMabs That Bind to Native CD47 on a Human Cell Line Correlate with Neutralization of Binding of Human CD47 to Human SIRP α LIST OF MONOCLONAL ANTIBODIES THAT BLOCK HUMAN CD47 BINDING TO CD47 IN mAb Clone ID BINDING TO SIRP α FACS ASSAY 5 + + 10 + + 14 + + 85 + + 87 + + 91 + + 101 + + 102 + + 106 + + 107 + + 139 + + 144 + + 151 + + 153 + + 161 + + 164 + + 143 +/− +/− 141 − +/− 90 +/− +/− 47 − +/−

Example 4 Determination of IC50 Values Neutralization of Binding of SIRP α to CD47 in ELISA

Concentrated monoclonal antibody for the top 18 anti-CD47 mAbs was used in the CD47-SIRP α neutralization assay to determine IC50 values. An assay format similar to that in Example 2 was performed, using an 8 fold 1:2 dilution series of antibody, from 10 μg/ml to 0.005 μg/ml. IC50 values were calculated using PRISM software. The sixteen antibodies with the lowest IC50 also completely block binding of CD47 binding to SIRP α.

TABLE 5 Antibody Isotype and IC50 Values for Neutralization of Binding of Human CD47 to Human SIRP α mAb ID Isotype IC50 (nM) 151 IgG1 2.0 91 IgG1 2.1 139 IgG1 2.2 102 IgG1 2.3 107 IgG1 2.7 106 IgG1 2.9 87 IgG1 3.0 161 IgG1 3.0 5 IgG1 3.5 14 IgG1 3.5 10 IgG2a 4.7 164 IgG1 4.8 85 IgG1 4.9 144 IgG1 10 101 IgG1 15 153 IgG1 27.9 90 IgG1 53.6 143 IgG1 96

Example 5 Induction of Macrophage Phagocytosis of Cells from a Human Tumor Cell Line

Neutralization of the binding of CD47 expressed on target cells to SIRP α expressed macrophages can induce macrophages to phagocytose the target cell. A cell based fluorescent assay similar to that used in WO 2013/119714 was used to assess a panel of the top five anti-CD47 mAbs that neutralize with the highest IC50 CD47/SIRP α binding for the ability to induce phagocytosis of a target human tumor cell line. CD47-expressing CCRF-CEM cells were incubated with 0.3 uM CFSE for 15 minutes at 37° C. and washed with PBS to remove CFSE. CFSE-labeled CCRF-CEM cells fluoresce in the FL-1 channel in FACS. CFSE-labeled CCRF-CEM cells were incubated with monocyte-derived human macrophages for 3 hr at 37° C. at a ratio of 4:1 CCRF-CEM cell to macrophage, with or without anti-CD47 mAbs. Monocyte-derived human macrophages are adherent. Non-adherent cells on the plate were washed away with PBS and the adherent cells were scraped off of the bottom of the plate. Macrophages with stained with anti-CD14 antibody conjugated with dye to fluoresce in the FL-4 channel in FACS. Macrophages that had phagocytosed the CCRF-CEM cells would also have ingested the CFSE dye and would fluoresce in the FL-1 channel in FACS. Double-positive FL-4+/FL-1+ cells are macrophages that have phagocytosed CFSE-labeled CCRF-CEM cells. The CD47 mAbs, antibody B6H12 (as a positive control) and an irrelevant mouse IgG1 mAb (as a negative control) were tested for the ability to induce phagocytosis at five concentration, of 1:10 dilutions from 10 μg/ml to 0.001 μg/ml. The data were expressed as the phagocytotic index, the percentage of CD14+ (FL-4+) cells that were also positive in the FL-1 channel in FACS (had ingested CFSE through phagocytosis of CFSE-labeled CCRF-CEM cells). Other mAbs in the panel that neutralize CD47/SIRP α binding in ELISA may also exhibit potent induction of macrophage phagocytosis of human tumor cells. The data show that mAbs potently induce phagocytosis of the CCRF-CEM human tumor cells by macrophages and that they do so more potently than control mAb B6H12. At a concentration of 0.1 μg/ml, the mAbs are still exhibiting significant induction of phagocytosis while the activity of B6H12 is approaching baseline established by the negative control mAb (FIG. 3).

Example 6 Screen for Induction of Hemagglutination of Human Erythrocytes by Monoclonal Antibodies Against Human CD47

The antibodies were screened for their induction of hemagglutination of human erythrocytes (RBCs). Human RBCs were diluted 1:10 in PBS and incubated at 37° C. with a 1:2 dilution of antibody from 50 nM to 0.05 nM. Humanized antibody B6H12 was used as a positive control and mouse IgG1 was used as a negative control. RBCs that have not undergone hemagglutination appear as a tight red dot. Hemagglutinated RBCs are more diffuse. Data are shown in FIG. 4. Antibody 102 exhibited no evident hemagglutination at the maximal tested concentration of 50 nM. In assays using higher concentrations, antibodies of the invention, including Antibody 102, will show no evident hemagglutination at concentrations up to 500 nM. Antibody 91 exhibited no evident hemagglutination at concentration of 25 nM and a small amount of hemagglutination at 50 nM. Therefore, antibody 102 is a therapeutic candidate antibody as it exhibits potent induction of phagocytosis of CCRF-CEM cells while exhibiting no hemagglutination of RBCs. Antibody 91 is also a candidate. Antibodies 91, 102, 87, 107 and 139 all appeared to be superior to humanized B6H12 as they exhibited more potent induction of phagocytosis of CCRF-CEM cells, while exhibiting no or lower hemagglutination of RBCs at higher concentrations than humanized B6H12. No prozone effect of hemagglutination was observed with any of the AlivaMab CD47 mAbs. Other AlivaMab antibodies exhibiting neutralization of CD47/SIRP α binding and induction of phagocytosis of human tumor cells by macrophages also showed no or limited hemagglutination at high concentrations and are therapeutic candidates.

Example 7 Sequences of Anti-CD47 VH and VL

Total RNA was extracted from hybridomas producing anti-CD47 monoclonal antibodies using the Qiagen RNeasy Mini kit (Cat No. 74104), followed by 5′ RACE, using the 5′ RACE system kit (Life Technologies, US cat #18734-058) with the following 3′ gene specific primers IgG 5′-GGTTCGGGGAAGTAGTCCTTGACC-3′ (SEQ ID NO:337) and IgK 5′-CCGATTGGAGGGCGTTATCCAC-3′ (SEQ ID NO:338). RACE products were gel purified and cloned into pCR4-TOPO using TOPO TA cloning kit for sequencing with One Shot Top 10 chemically competent E. coli (Life Technologies, US Cat #K4575-01). Sequencing of vector containing colonies was performed by Sequetech (Mountain View, Calif.) using M13F or M13R sequencing primers. The reported nucleotide sequences start at the first nucleotide in the first codon for the amino terminal amino acid in framework 1. The reported polypeptide sequences are based on an in silico translation of the nucleic acid sequence and start at the first amino acid at the amino terminus of framework 1.

Example 8 Epitope Binning

A competition ELISA was performed to establish competitive binding bins. ELISA plates were coated with 1 μg/ml huCD47 protein (Sino Biological, China 10161-H08H) and blocked with Superblock (Thermo Scientific #37518). After washing, wells were incubated with an AlivaMab monoclonal antibody representing one of seven unique competition bins. After 1 hour the wells were washed and incubated with individual clonal anti-huCD47 AlivaMab hybridoma supernatants. After another hour the wells were washed and incubated with a specific secondary antibody that either recognized human kappa light chain (LC) or human lambda LC depending on which AlivaMab Mouse supernatants were being detected (Southern Biotech Goat X hu kappa LC #2061-05 or Bethyl Goat X hu lambda LC #A80-116P) and detected with Supersignal ELISA Pico Chemiluminescent substrate (Thermo Scientific—Product #37069) (Tables 5 and 6). Individual AlivaMab Mouse antibodies that were able to bind in the presence of a mouse antibody are considered to be in a unique epitope bin from that particular mouse antibody. Individual AlivaMab Mouse antibodies that were unable to bind in the presence of a mouse antibody are considered to be in the same epitope bin as that particular mouse antibody. In this way multiple epitope bins were defined for huCD47 binding antibodies (Tables 3 and 6, FIG. 5).

TABLE 6 Multiple Epitope Bins Bin 1 Bin 2 Bin 3 Bin 4 Bin 5 Bin 6 Bin 7 All CD47 12 7 5 7 1 26 3 AlivaMabs by bin Functional 5 107 91 151 mAbs 14 161 106 139 Assigned 10 85 87 102 to Epitope 144 101 164 Bin 153 90 143

Example 9 Affinity Determination

Affinity was determined for five selected AlivaMab Mouse monoclonal hybridoma supernatants (Biosensor Tools, Salt Lake City, Utah). Binding kinetics were measured at 25° C. using a BioRad ProteOn XPR36 optical biosensor equipped with GLM sensor chips and equilibrated with running buffer (HBS, 0.005% TWEEN-20, 0.1 mg/mL BSA, pH 7.4).

The tested antibodies were AlivaMab antibodies: 91, 102, 107, 139 and 151. Kinetics of binding each mAb to recombinant human CD47 (Novoprotein cat no. C321, lot no. 0329689) was measured.

The analyses were performed by capture of the mouse antibodies on sensor surfaces coated with an anti-mouse capturing agent.

CD47 Binding to Five AlivaMab Anti-CD47 Antibodies

The five antibodies were captured to densities of 850-1030 RU onto an anti-mouse Fc surface. CD47 was tested in a three-fold dilution series starting at 100 nM.

These binding data were also fit to a 1:1 interaction model:

Within the panel of AlivaMab Mouse anti-CD47 antibodies, there are antibodies with KD values below a nanomolar and KD values in the low nanomolar range, and with fast k_(on) and slow k_(off) rates (Tables 7-9).

TABLE 7 Binding Kinetics of Anti-CD47 IgG AlivaMab mAbs mAb ka (M⁻¹ s⁻¹) kd (s⁻¹) K_(D) (pM) 91 7.2(2)e6 1.111(3)e−3  154.4(7) pM 102 6.9(2)e6 2.21(7)e−3 320(3) pM 107 5.7(1)e6  9.3(2)e−4 163(1) pM 139 1.18(6)e6     1.00e−5* 8.5(4) pM 151 8.7(4)e6 08.9(4)e−3 1.002(8) nM *No decay was detected in the responses from the 139A surface during the dissociation phase. This indicates the complex dissociated very little during this time. Therefore, the dissociation rate constant was fixed at 1×10⁻⁵ s⁻¹ during the fitting process so the KD must be considered a rough estimate.

Table 8 summarizes the parameters determined from these measurements.

TABLE 8 Summary of Binding Kinetics of Anti-CD47 mAbs Binding constants determined at 25° C. k_(a) (M⁻¹ s⁻¹) k_(d) (s⁻¹) K_(D) (pM) m91A 7.2(2)e6 1.11(3)e−3  150(10) m102A 6.9(2)e6 2.21(7)e−3  320(10) m107A 5.7(1)e6 9.3(2)e−4 160(10) m139A 1.18(6)e6      1e−5** ~9 m151A 8.7(4)e6 8.9(4)e−3 1000(100) * average of measurements from three antibody surfaces **this dissociation rate constant was fixed at 1e−5 s⁻¹

Another way to compare these five antibodies is to bin and rank them by their dissociation rate constants.

TABLE 9 Binning and Ranking of Anti-CD47 mAbs by Their Dissociation Constants Antibodies binned by k_(d)'s determined at 25° C. fastest slowest ~10⁻² s⁻¹ ~10⁻³ s⁻¹ ~4 × 10⁻⁴ s⁻¹ ≤10⁻⁵ s⁻¹ m151A m107A hB6412 m139A m91A hAb6.12 m102A

AlivaMab antibody 139A appeared to have a very slow dissociation rate constant.

In summary, CD47 showed binding to all five antibodies, with affinities that ranged from ˜10 pM to ˜1.5 nM.

The 139A/CD47 complex was so stable that a dissociation rate constant could not be reliably determined from these analyses.

Example 10 AlivaMab Mouse Anti-CD47 mAbs and their Fully Human Derivatives Bind to and Neutralize CD47 from Cynomolgus Monkey

CD47 is cloned and expressed from cynomolgus monkey using standard molecular biological techniques. The recombinant CD47 may be tagged (histidine, Fc) to support efficient purification. The recombinant cynomolgus CD47 may also be transiently or stably expressed on cell lines. The AlivaMab Mouse anti-CD47 mAbs and their human variants are shown to bind to cynomolgus monkey CD47. The AlivaMab Mouse anti-CD47 mAbs and their human variants are shown to neutralize cynomolgus monkey CD47 in assays as described above for human CD47.

Example 11 AlivaMab Mouse Anti-CD47 mAbs and their Fully Human Derivatives Bind to and Neutralize CD47 from Mouse

CD47 is cloned and expressed from mouse using standard molecular biological techniques. The recombinant CD47 may be tagged (histidine, Fc) to support efficient purification. The recombinant mouse CD47 may also be transiently or stably expressed on cell lines. The AlivaMab Mouse anti-CD47 mAbs and their human variants are shown to bind to mouse CD47. The AlivaMab Mouse anti-CD47 mAbs and their human variants are shown to neutralize mouse CD47 in assays as described above for human CD47.

Example 12 Conversion of AlivaMab Mouse Anti-CD47 mAbs to Fully Human

The AlivaMab Mouse anti-CD47 mAbs are easily converted, expressed recombinantly and purified as fully-human antibodies of any isotype. The recombinant fully-human antibody retains all of the characteristics of the parental AlivaMab Mouse antibody. For example, the nucleotide sequences of the heavy and light chain variable region are synthesized into DNA by contract research organization such as Lake Pharma (Belmont Calif.) and then, using vectors for recombinant expression in mammalian cells, the VH cloned in-frame with coding sequences for the human isotype of choice IgG1, IgG2, or IgG4 constant regions and including modified versions thereof that are known in the art and the Vκ cloned in-frame with coding sequences for the human Cκ region. The Fc regions may be modified for either increased or decreased effector function such as C1q binding or FcR binding. In particular the antibody isotype may be human IgG4, which may exhibit lowered antibody dependent cellular cytotoxicity than human IgG1 or human IgG2. The middle hinge and or the Fc of the human IgG4 may be modified (for example, see U.S. Pat. No. 8,911,726 and disclosures and references therein.) IgG4 may also be modified to drive inter-chain disulfide bonds rather intra-chain to better ensure homodimeric IgG4 rather than monomeric or heterodimeric formation (replacement of the middle hinge region with that from human IgG1; mutation S228P/L235E; mutation of serine 229 to proline (Bloom et al., Protein Sci. (1997) 6:407-15); see also Peters et al., J. Biol. Chem. 2012). Vectors are then transformed into HEK293 cells for expression of recombinant fully human antibody. Fully human IgGκ mAb versions of the selected AlivaMab mAb are purified from tissue culture supernatants using protein A. The fully human versions retain all of the characteristics of the parental chimeric AlivaMab.

In additional examples, the CD47 antibodies will exhibit anti-tumor activities in human tumor xenograft models in mice such as the Raji model of lyphoma. The antibodies will exhibit anti-tumor activities in preventative models and eradication models.

The epitopes of the AlivaMab CD47 antibodies can be epitope mapped by various methods known in the art. The panel of epitopes on CD47 will include linear and conformational epitopes. Key contact amino acids in the epitope can be discerned by site-direct mutagenesis or by solving the crystal structure of the antibody-CD47 binding interaction. The antibodies that neutralize CD47/SIRP α binding will have different epitopes. Some epitopes will overlap structurally and will have some overlapping and some different key contact residues. Some epitopes will be not overlap structurally with epitopes of other antibodies. Unique epitopes will correlate with unique activities of antibodies. 

1-15. (canceled)
 16. A method of treating or preventing a disease or disorder associated with CD47 and/or SIRPα or aberrant expression thereof in a human subject in need thereof, the method comprising administrating to said subject a therapeutically effective amount of an anti-CD47 antibody, or an antigen-binding fragment thereof, comprising a) a heavy chain variable region comprising a VHCDR1, a VHCDR2, and a VHCDR3 and b) a light chain variable region comprising a VLCDR1, a VLCDR2, and a VLCDR3, wherein: i) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 22, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 43, VHCDR3 comprises the amino acid sequence of SEQ ID NO: 64 the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 106 the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 127, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 148; ii) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 23, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 44, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 65, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 107, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 128, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 149; iii) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 24, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 45, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 66, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 108, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 129, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 150; iv) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 25, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 46, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 67, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 109, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 130, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 151; v) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 26, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 47, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 68, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 110, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 131, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 152; vi) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 27, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 48, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 69, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 111, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 132, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 153; vii) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 28, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 49, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 70, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 112, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 133, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 154; viii) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 29, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 50, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 71, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 113, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 134, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 155; ix) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 30, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 51, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 72, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 114, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 135, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 156; x) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 31, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 52, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 73, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 115, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 136, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 157; xi) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 32, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 53, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 74, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 116, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 137, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 158; xii) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 33, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 54, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 75, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 117, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 138, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 159; xiii) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 34, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 55, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 76, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 118, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 139, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 160; xiv) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 35, the VHCDR2 comprising the amino acid sequence of SEQ ID NO: 56, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 77, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 119, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 140, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 161; xv) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 36, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 57, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 78, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 120, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 141, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 162; xvi) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 37, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 58, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 79, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 121, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 142, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 163; xvii) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 38, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 59, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 80, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 122, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 143, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 164; xviii) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 39, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 60, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 81, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 123, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 144, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 165; xix) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 40, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 61, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 82, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 124, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 145, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 166; xx) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 41, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 62, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 83, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 125, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 146, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO: 167; or xxi) the VHCDR1 comprises the amino acid sequence of SEQ ID NO: 42, the VHCDR2 comprises the amino acid sequence of SEQ ID NO: 63, the VHCDR3 comprises the amino acid sequence of SEQ ID NO: 84, the VLCDR1 comprises the amino acid sequence of SEQ ID NO: 126, the VLCDR2 comprises the amino acid sequence of SEQ ID NO: 147, and the VLCDR3 comprises the amino acid sequence of SEQ ID NO:
 168. 17. The method of claim 16, wherein the disease or disorder is a proliferative disease or disorder.
 18. The method of claim 17, wherein the proliferative disease or disorder is a neoplasm, a tumor or a metastasis.
 19. The method of claim 17, wherein the proliferative disease or disorder is cancer.
 20. The method of claim 16, wherein the disease or disorder is ischemic-reperfusion injury.
 21. The method of claim 20, wherein the ischemic-reperfusion injury occurs during a transplant.
 22. The method of claim 16, wherein the disease or disorder is an immunological disease.
 23. The method of claim 22, wherein the immunological disease is an inflammatory disease.
 24. The method of claim 22, wherein the immunological disease is an autoimmune disease.
 25. The method of claim 16, wherein the disease or disorder is associated with CD47 overexpression.
 26. The method of claim 16, wherein the anti-CD47 antibody is administered alone or in combination with one or more agents.
 27. The method of claim 26, wherein the agent is selected from: a cytotoxic agent, a chemotherapeutic agent, a cytokine, an anti-angiogenic agent, a tyrosine kinase inhibitor, a toxin, a radioisotope, and combinations thereof.
 28. The method of claim 18, wherein the anti-CD47 antibody induces phagocytosis of tumor cells by macrophages.
 29. The method of claim 16, wherein the anti-CD47 antibody induces little to zero hemagglutination of human erythrocytes.
 30. The method of claim 29, wherein the anti-CD47 antibody induces zero hemagglutination of human erythrocytes. 